- 期刊
- OpenAccess
Orbital Floor Reconstruction with an Absorbable Vicryl (Polyglactin 910) Mesh
使用可吸收的Vicryl(polyglactin 910)網板植入物來重建眼窩底部骨折
摘要
目的：長久以來，對於使用何種性質的植入物來重建眼窩骨折一直存在著爭議。在本篇文章中，我們嘗試使用可吸收性的植入物：Vicryl(Polyglactin 910)網板，來重建非大範圍或複雜性的眼窩底部骨折。 方法：從2000年一月到2001年十二月間，七位被診斷為眼窩底部骨折的病患，且都非大範圍或複雜性的眼窩底部骨折。這七位病患均因為呈現持續性複視及其中三位合併有眼球內陷大於2mm而接受修補手術；我們皆使用可吸收的植入物做眼窩骨折重建，術後追蹤期從2.5個月到25個月（平均17.1個月）。 結果：手術過程及術後無任何併發症產生。於術後長期追蹤下，七位病患其中心視野的複視現象和先前眼球轉動受限的情形皆獲得改善；術後亦無任何病人有眼球內陷的情形。但其中一位病患曾在術後隔天因為複視和眼球轉動受限情形無明顯改善而再次接受手術檢查。 討論：可吸收性的植入物具備良好穩定的生化適合性，容易處理，方便植入，且在多年後不會有眼窩內依舊存在外來物質的疑慮，明顯降低感染或擠出曝露植入物的機會。雖然這七個病例皆不是大範圍或合併多個眼眶壁的眼窩骨折，但我們認為是一種不錯的選擇。我們還需要更大量的病例和更長的追蹤期來確定其效果。
關鍵字
無資料並列摘要
Purpose: What is the ideal material for orbital floor reconstruction remains controversial. Many kinds of implants, generally divided into autogenous and alloplastic, have been used to repair the orbital floor defects. This report presents the results of our orbital fractures repaired with Vicryl (polyglactin 910) mesh implants. Materials and methods: From January 2000 to December 2001, seven patients with orbital floor fractures were enrolled in this study. They were five males and two females, aged 16-51 (median age 29.6). All seven patients had diplopia; three of them had diplopia combined with enophthalmos greater than 2mm. All subjects took the pre-operative orbital computed tomographic scans to detect the site of all fractures. The operation we performed on these seven patients was orbital floor fracture repair via a subciliary approach, with Vicryl (polyglactin 910) mesh implants placed in all of them. As for the timing of operation, all subjects were operated nine or more days after the initial trauma. Post-operatively, the follow-up period of all patients averaged 17.1 months (ranging from 2.5 to 25 months). Results: There were no intra-operative complications. After two months, six of the seven patients had their diplopia improved at the central field of gaze. We performed a reoperation on one patient due to persistent signs of diplopia and limitation of the motility. Then the symptoms subsided after half a year having no obvious connection with the reoperation. Post-operative enophthalmos was not found in any patients. In addition, none of them had extrusion, infection, or displacement of the implant. Conclusions: More cases and longer follow-up are needed to evaluate the outcome of using Vicryl mesh implants to repair orbital floor detects. Nevertheless, in view of the good biocompatibility with orbital tissues, minimal inflammatory reaction, easy shaping and handling, Vicryl mesh could be considered a good alternative in non-multi-wall or non-large orbital floor fracture repair.